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The prevalence of dementia is increasing globally as populations grow older. Moderate and severe dementia are the main reasons for older people entering long-term care in Finland, and the vast majority of nursing home residents have it. Regarding mild dementia, religiousness is known to slow the progress of the disease, offer solace, and maintain a life-long identity. However, we know practically nothing about the religiousness of people with severe dementia. This study sought to fill the gap by interviewing Lutheran chaplains working in Finnish nursing homes. The data were subjected to qualitative content analysis to understand: (I) how people with severe dementia may express their remaining religiousness and (II) how the chaplains asserted the religiousness of people whom their words often did not reach. The clearest expressions of religiousness found were bodily, including expressions of emotions and fumbling liturgical movements. The chaplains utilized prayer services, active presence, and generational intelligence to respond to residents’ religiousness. The main conclusion is that people with severe dementia can express their faith and are eager to practice it when opportunities are provided to do so. Our research challenges care providers and religious communities to better acknowledge the religiousness of people with severe dementia.

Funding Information: This work was supported by the Päivikki and Sakari Sohlberg Founda-tion and the Björkqvist Fund. The work was done in the framework of the Gerontology Research Center (GEREC) and the Centre of Excellence in Research on Ageing and Care (CoE AgeCare). We would like to thank all the people living and working in and visiting the ALF for giving us a window into their everyday life in the facility. We especially wish to thank staff members for helping us arrange the group discussion and interviews and all the residents who took part in them. Funding Information: This work was supported by the Päivikki and Sakari Sohlberg Foundation and the Björkqvist Fund. The work was done in the framework of the Gerontology Research Center (GEREC) and the Centre of Excellence in Research on Ageing and Care (CoE AgeCare). We would like to thank all the people living and working in and visiting the ALF for giving us a window into their everyday life in the facility. We especially wish to thank staff members for helping us arrange the group discussion and interviews and all the residents who took part in them. Publisher Copyright: © The Authors. Assisted living facilities are presented as the older person’s home but, at the same time, defined by institutional and communal characteristics. Using Goffman’s (1974/1986) concept of frame, we aim to find out how home, institution and community frames define social roles and shape social relationships and interaction in assisted living facilities. Directed content analysis was used to analyse the data consisting of observations, one group discussion and ten individual interviews with residents in an assisted living facility. We found that the home frame was characterised by meaningfulness, spontaneousness and informality of social relationships and interaction, whereas the institution frame by indifference and formality of them. Acknowledging and tolerating other people was not only central in the community frame but also dissociating oneself from some people. Frames can shed light on how different interpretations of the multifaceted social environment of assisted living affect homeliness of the facility and well-being of the residents.

Background Visiting a close relative who resides in a nursing home is an opportunity for family members to extend their caring roles and find reassurance that the older person’s life is continuing as well as possible. At the same time, visits allow family members to observe the quality of formal care in the facility. In Finland, the COVID-19 pandemic led to the imposition of visiting bans in nursing homes in March 2020, thereby preventing customary interaction between residents and their family members. The aim of this study is to investigate family members’ experiences of the visiting ban and its effects on their concern over the wellbeing of close relatives living in nursing homes. Methods A cross-sectional study was conducted to explore family members’ self-reported concerns and the factors associated with those concerns. In the context of this unpredictable pandemic, this was considered an appropriate approach, as information at the very beginning of the visiting ban was sought, and causal relations were not investigated. The data consist of a quantitative survey (n = 366) conducted among family members in May–June 2020. Binary logistic regression analyses were performed to explore the association between the independent variables and reported concern. Results The results showed that increased concern was extremely common (79%). The factors associated with this notable increase were adequacy of contact and information, observations of changes in the wellbeing of the relative in question, and doubts over the appropriateness of the visiting restriction. Conclusions In light of the findings, care providers should improve their information provision to residents’ family members and find new ways of allowing visits to nursing homes in the future in all circumstances.

Muistisairaudet yleistyvät Suomessa väestön ikääntyessä. Hoivakotien asukkaista jo nyt valtaosalla on diagnostisoitu muistisairaus. Perustuslaki takaa kaikille oikeuden ilmaista ja harjoittaa omaa uskontoaan, mutta miten oikeus taataan silloin, kun ihminen ei sairautensa vuoksi edes muista aina olevansa uskossa? Artikkelissa tutkin, millaisin keinoin evankelis-luterilaisen kirkon papit tukevat vaikeasti muistisairaiden ihmisten uskonnollisuutta hoivakodeissa. Tutkimusaineisto koostuu kymmenestä papin teemahaastattelusta. Olen analysoinut aineistoa sekä aineistolähtöisen että teoriaohjaavan sisällönanalyysin keinoin. Teoreettisena viitekehyksenä toimii vammaisuuden teologia. Tulosten mukaan muistisairaiden ihmisten uskonnollisuutta tuetaan mahdollistamalla kirkollisiin tilaisuuksiin osallistuminen erityisesti hartauksissa ja tarjoamalla mahdollisuuksia henkilökohtaisiin kohtaamisiin papin kanssa. Muistisairaiden uskonnollisuuden tukemisessa pappeja auttaa sukupolvitaju eli ymmärrys parhaillaan hoivakodeissa asuvien ihmisten sukupolvikokemuksista. Papin näkyvillä ja saatavilla oleminen hoivakodissa on myös tärkeä työkalu muistisairaiden asukkaiden uskonnollisuuden tukemisessa. Artikkeli osoittaa, että uskonnollisuutta voidaan tukea vielä silloinkin, kun ihminen on muistisairautensa vuoksi jo sanallisen kommunikaation ulottumattomissa.

There is an urge to introduce high technology and robotics in care settings. Assisted living (AL) is the fastest growing form of older adults’ long-term care. Resident autonomy has become the watchword for good care. This article sheds light on the potential effects of care robotics on the sense of autonomy of older people in AL. Three aspects of the residents’ sense of autonomy are of particular interest: (a) interaction-based sense of autonomy, (b) coping-based sense of autonomy, and (c) potential-based sense of autonomy. Ethnographical data on resident autonomy in an AL facility and existing literature on care robots are utilized in studying what kind of assurances different types of robots would provide to maintain the sense of autonomy in AL. Robots could strengthen the different types of sense of autonomy in multiple ways. Different types of robots could widen the residents’ space of daily movements, sustain their capacities, and help them maintain and even create future expectations. Robots may strengthen the sense of autonomy of older persons in AL; however, they may simultaneously pose a threat. Multi-professional discussions are needed on whether robots are welcomed in care, and if they are, how, for whom, and in what areas. There is an urge to introduce high technology and robotics in care settings. Assisted living (AL) is the fastest growing form of older adults’ long-term care. Resident autonomy has become the watchword for good care. This article sheds light on the potential effects of care robotics on the sense of autonomy of older people in AL. Three aspects of the residents’ sense of autonomy are of particular interest: (a) interaction-based sense of autonomy, (b) coping-based sense of autonomy, and (c) potential-based sense of autonomy. Ethnographical data on resident autonomy in an AL facility and existing literature on care robots are utilized in studying what kind of assurances different types of robots would provide to maintain the sense of autonomy in AL. Robots could strengthen the different types of sense of autonomy in multiple ways. Different types of robots could widen the residents’ space of daily movements, sustain their capacities, and help them maintain and even create future expectations. Robots may strengthen the sense of autonomy of older persons in AL; however, they may simultaneously pose a threat. Multi-professional discussions are needed on whether robots are welcomed in care, and if they are, how, for whom, and in what areas.

Transfer from a private home to an assisted living facility has been pictured as a major change in an older person's life. Older people themselves tend to perceive the change as something eventual that breaks the bonds and familiarities of previous life. The aim of this article is to shed light on residents’ chances to reach affiliation (as Nussbaum defines it) in their new living surroundings, and thus adjust to that social environment. Based on ethnographical data gathered in a Finnish sheltered home in 2013–14, we studied residents’ affiliations through ruptures, namely residents’ perceived social isolation. Social isolation was found to be connected with two separate social worlds: the one inside the facility and the one outside. Social isolation resulted from different factors connected to the quality of social interaction with co-residents and the staff, daily routines of the institution and residents’ personal life histories. Also, residents’ older friends seemed to avoid visiting care facilities which caused perceived social isolation. This article deepens the insights into the perceived social isolation of assisted living and thus helps care providers to create new strategies to enable due affiliation for their residents.

Culturally, institutional care has been seen to strip older people of their status as full adult members of society and turn them into ‘have-nots’ in terms of agency. The substantial emphasis in gerontology of measuring the activity and functional ability of the elderly has unintentionally fostered these stereotypes, as have traditional definitions of agency that emphasise individuals’ choices and capacities. The aim of this paper is to discover what kind of opportunities to feel agentic exist for people who have reduced functional abilities and therefore reside in assisted living. In this paper, agency is approached empirically from the viewpoint of Finnish sheltered housing residents. The data were gathered using participant observation and thematic interviews. This study suggests that even people with substantial declines in their functional abilities may feel more or less agentic depending on their functional and material surroundings and the support they receive from the staff, relatives and other residents. The perception that residents’ agency in assisted living cannot be reduced to measurable activity has methodological implications for gerontological research on agency. Care providers can utilise our findings in reasserting their residents’ quality of life.

The concept of resident-facility fit has largely been used to illustrate whether a residential care facility and a resident are together able to meet requirements set by only the hampering functional abilities of the latter. The purpose of this paper is to study how assisted living residents perceive resident-facility fit. The data were gathered ethnographically from both observations and resident interviews in a sheltered home in Finland during 2013-2014. Perceived resident-facility fit is based on several relational factors that connect to both the residents as individuals and their surroundings. This fit seems also to be partly conditional and indeed depends on residents' trust in having their own potential to act. Good resident-facility fit results in feeling at home in a facility, whereas poor fit can even result in residents' feeling imprisoned. Care providers can thus utilize our results to affirm residents' quality of life in residential facilities.

Becoming a resident in a long-term care facility challenges older people's continuity of self in two major ways. Firstly, as they leave behind their previous home, neighborhood, and often their social surroundings, older people have to change their life-long lifestyles, causing fears of the loss of one's self. Secondly, modern-day care facilities have some features of 'total' institutions that produce patient-like role expectations and thus challenge older people's selves. Our ethnographic study in a geriatric hospital and a sheltered home in Finland aims to find out what features of daily life either support or challenge older people's continuity of self. A philosophical reading of the concept of recognition is used to explore how various daily practices and interactions support recognizing people as persons in long-term care. Categories of institution-centered and person-centered features are described to illustrate multiple ways in which people are recognized and misrecognized. The discussion highlights some ways in which long-term care providers could use the results of the study.

Autonomy is a pervasive concept in Western lifestyles today. However, people in the fourth age are assumed not to be autonomous but dependent on other people. The data of this study consisted of interviews with Finnish community-dwelling 90–91-year-old people. The study aim was to examine how these people see their own autonomy in their everyday lives. The analysis was based on membership categorisation analysis. Our respondents considered their autonomy through three distinct themes. Functional ability was considered in terms of being physically capable of managing daily tasks. Independence in decision making was based on material and financial self-sufficiency and on the respondents' supposition that they were capable of making decisions due to an absence of memory disorders. Additionally, autonomy was considered as contesting norms of age-appropriateness. Among respondents, chronological age seemed to have been replaced by functional and cognitive ability as a definer of categorisations; age-others became ability-others. Our study revealed that the perceptions of autonomy also included gendered features as they were linked with differing gendered ideals, roles and life domains of women and men. The results highlight the internal diversity among the oldest old and challenge the third/fourth age division. Instead, they suggest the existence of a certain ‘grey area’ within old age, and urge an analysis on the subtle meaning making involved in older people's constructions of age-categorisations.

The ageing populations of the Western world present a wide range of economic, social, and cultural implications, and given the challenges posed by deteriorating maintenance ratios, the scenario is somewhat worrying. In this paper, I investigate whether Martha C. Nussbaum's capabilities approach could secure dignity for older people in long-term care, despite the per capita decreases in resources. My key research question asks, ‘What implications does Nussbaum's list of central human capabilities have for practical social care?’ My methodology combines Nussbaum's list with ethnographic data gathered from a Finnish sheltered home for older people. On the basis of this study, it seems that the capabilities approach is a plausible framework for the ethics of care because it highlights differences in the ability to function and thus differences in opportunities to pursue a good life. The ideas presented in this article could assist social policy planners and executives in creating policies and practices that help old people to maintain their dignity until the end of their days.

The ageing populations of the Western world present a wide range of economic, social, and cultural implications, and given the challenges posed by deteriorating maintenance ratios, the scenario is somewhat worrying. In this paper, I investigate whether Martha C. Nussbaum's capabilities approach could secure dignity for older people in long-term care, despite the per capita decreases in resources. My key research question asks, 'What implications does Nussbaum's list of central human capabilities have for practical social care?' My methodology combines Nussbaum's list with ethnographic data gathered from a Finnish sheltered home for older people. On the basis of this study, it seems that the capabilities approach is a plausible framework for the ethics of care because it highlights differences in the ability to function and thus differences in opportunities to pursue a good life. The ideas presented in this article could assist social policy planners and executives in creating policies and practices that help old people to maintain their dignity until the end of their days.

The paper deals with innovative handling technologies of container terminals enabling the automation of transport and storage processes at terminal quayside and within the yard area. The presented shuttle carrier concept is based on the employment of Automated Shuttle Carriers® in combination with rail mounted stacking cranes, automatically operating storage blocks, arranged perpendicular to the quay wall. Beside a scenario-based investigation of system performance, by means of simulation, the shuttle carrier concept is compared with a conventional handling system using yard tractors for container transport and rubber-tyred gantry cranes for yard operation. The system comparison delivers results in terms of equipment and manning requirements as well as insights into the environmental impact of system operation, considering also rubber-tyred gantry cranes powered by electric energy.

Vanhojen ihmisten kuoleminen tehostetussa palveluasumisessa sairaaloiden ja terveyskeskusten sijaan on Suomessa verrattain uusi ja nopeasti yleistyvä ilmiö, josta emme kuitenkaan tiedä juuri mitään. Aiempi vanhojen ihmisten kuolemaa tarkastellut tutkimus on keskittynyt joko kodin tai laitoksen ympäristöihin, ja palvelutalo sijoittuu instituutiona näiden välimaastoon. Helsingin yliopiston valtiotieteellisessä tiedekunnassa (sosiaaligerontologia) alkoi maaliskuussa 2020 Kuoleman ja kukkaron välissä: muistisairaan vanhuksen elämän loppuvaiheen hoidon haasteet -tutkimushanke, jota rahoittaa Koneen säätiö. Kolmevuotisen hankkeen aikana on tarkoitus paitsi tutkia muistisairaiden ihmisten kuolemisen prosessia ja olosuhteita, myös tehdä näkyväksi, mitä kuoleminen palvelutaloissa tarkoittaa kuoleman prosessiin osallistuvien (asukkaat, läheiset, hoitohenkilöstö) kannalta. Tutkimushankkeen tuloksia tullaan esittämään paitsi tieteellisissä ja muissa kirjallisissa julkaisuissa, myös audiodokumentteina ja taiteellisina esityksinä. Esittelemme tässä kirjoituksessa lyhyesti hankkeen taustan, tavoitteet ja tutkimusmenetelmät. Termillä palvelutalo viittaamme tässä kirjoituksessa tehostetun palveluasumisen yksiköihin. Non